Genital ulcers

A presumptive diagnosis of genital herpes commonly is made on the basis of the presence of dark-field-negative, vesicular, or ulcerative genital lesions. A history of similar lesions or recent sexual contact with an individual with similar lesions also is useful in making the diagnosis. 

In a review of lichenoid drug eruptions, lithium was implicated in one patient with ulcerative oral lesions and in another with ulcerative genital lesions (407). 

Formation of papules, bullae, or ulceration Excessive oozing Presence of genital discharge Concurrent fever... 

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

Haemophilus ducreyi, a gram-negative bacterium, has been isolated as the causative organism of chancroid, a genital ulcerative disease usually accompanied by inguinal lymphadenitis and bubo formation. Chancroid may possibly spread to other anatomic sites, a clinical feature first discovered by Ducrey in 1889.37... 

Genital ulcers (painless) Genital/anal warts Pharyngitis Proctitis Salpingitis... 

Genital ulcer disease caused by Haemophilus ducreyi (chancroid) Single 1 g dose. 

Signs and symptoms of superinfections, including anal or genital pruritus, black hairy tongue, vomiting, diarrhea, fever, sore throat, and ulceration or changes of... 

Signs and symptoms of superinfection including anal or genital pruritus, changes or ulceration of the oral mucosa, moderate to severe diarrhea, and new or increased fever... 

Superinfection, manifested as genital or anal pruritus, ulceration or changes in oral mucosa, and moderate to severe diarrhea, may occur. 

Topical sucralfate (4-10%) is also useful in management of decubitus ulcer, diabetic ulcers, chemical and thermal burns, radiation induced skin damage, vaginal ulceration, oral and genital ulceration. 

The use of aloe as a laxative is mentioned in Greek literature before the first century. The Greek physician Dioscorides wrote of its use in treating wounds, chapping, hair loss, genital ulcers, hemorrhoids, boils, mouth irritation, and inflammation. In the 7th century, aloe was used in the East for eczema and sinusitis. Today, aloe is often prescribed to heal wounds, bums, skin ulcers, frostbite, and dry skin. It is an ingredient in teas for dieters because of its laxative effect and is found in body-cleansing products as well (see Chapter 12). 

Dermal/Ocular Effects. Schonning (1966) described a case of a 57- year-old man who accidentally spilled acrolein over his genital area. Swelling of the penis and scrotum occurred, and after 15 days the genital area was deeply ulcerated and gangrenous. No follow-up information was provided. Lacroix et al. (1976) applied a solution of 10% acrolein in ethanol to 12 volunteers the skin was biopsied 48 hours later. All subjects exhibited irritation and had papillary edema, and 11 had polymorphonuclear infiltrates. In addition, five cases of epidermal necrosis occurred. No further information was provided. 

Aloes have been used on the skin to reduce the pain and swelling of bums, improve the sjmptoms of genital herpes and other skin conditions such as psoriasis, and to help heal wounds and frostbite. Aloe has been used orally to treat arthritis, asthma, diabetes, pruritus, peptic ulcers, and constipation. It may be effective in inflammatory bowel disease (1). It may reduce blood glucose in diabetes mellitus and blood Upid concentrations in hyperlipidemia (2). 

Gardner-Medwin JM, Smith NJ, Powell RJ. Clinical experience with thalidomide in the management of severe oral and genital ulceration in conditions such as Behget s disease use of neurophysiological studies to detect thalidomide neuropathy. Ann Rheum Dis 1994 53(12) 828-32. 

Genital ulcers (painful) Hemophilus ducreyi, herpes simplex virus Usually multiple vesicular/pustular (herpes) or papular/pustular (H. ducreyi) lesions that may coalesce painful, tender lymphadenopathy ... 

Genital ulcers (painless) Treponema pallidum Usually single papular lesion... 

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